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  Discussion on 2 yo thoroughbred filly with hock injury and infection
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Member:
Bernieh

Posted on Monday, Jan 15, 2007 - 8:47 am:

Dear Dr O,
I have read your information on infections of the bones and joints and have had 6 or more vet visits for this problems but not getting resolution of lameness. Would appreciate your advice.
2yo Thoroughbred filly. Spelling in paddock that likely had barbed wire. About 3 January 2007 noted to have small wound over posterior aspect of right hock. Also had marks on posterior aspect of left leg round hock suggestive of barbed wire scratches. Topical antiseptic (?type) applied. About 7 January 2007, noted to be lame for first time in right hind leg. Swelling of right hock. Also appeared to be unwell with fever, malaise, off food. Seen by vet who diagnosed infected hock joint secondary to penetrating injury. Joint needled, drained some cloudy fluid and joint flushed. Sinus draining at front of joint (?needle exit site). Treated with butazolidin, penicillin, gentamicin, metronidazole. Improved quickly. Lameness and general health better. Antibiotics stopped after 5 days (12 January). Became lame within 36 hours in same limb with problem in same joint. On lower dose of BTZ. Blood count shows normal white cell count, elevated serum fibrinogen. Swab taken on antibiotics shows untypable gram positive coccus susceptible to penicillin. Vet advises restart antibiotics. Question: I note the common organisms that cause septic arthritis in your info and the advice that treatment continue for 14 days after apparent resolution. Vet advises that GI upset common with prolonged courses of antibiotics. Any use to do X ray or other imaging at this stage? Any likelihood of foreign body, unusual pathogen like atypical mycobacteria or fungus or still most likely the usual bacteria?
Thanks in advance for your advice
Moderator:
DrO

Posted on Tuesday, Jan 16, 2007 - 7:06 am:

Hello Bernie,
Yes joint spaces are slow to have infection completely resolve and the results of even several days of infection can be devastating so antibiotic therapy should be prolonged.

The main question that must be answered here is which of the hock joint spaces are effected: as described in the article on septic arthritis this is critical to treatment and prognosis. There are actually 4 jts in the hock with the upper two dependably communicating. For more on this see, References > Equine Illustrations > Leg Anatomy and Conformation > Hock: anatomy and intrarticular injections.
DrO
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